Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994648 DEA: 070W3904 EFIS: 0722000045
QA Service Level: 1
DIST-CO-RTE-PM: 07-VEN-101-10.7/26.7
Work Description: SLURRY SEAL.
Location Description: VENTURA COUNTY FROM CAMARILLO SPRINGS ROAD UNDERCROSSING IN CAMARILLO TO MAIN STREET UNDERCROSSING IN VENTURA
Contractor Name: INTERMOUNTAIN SLURRY SEAL, INC.
Contractor Address: 1120 TERMINAL WAY, RENO NV 89502
Resident Engineer: Denrick Bautista Structure Rep.: Unknown
DIME Sample ID: 2024-01-14-6
TL Number from the TL Form:
Sample Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Sample Organization Contact: (213) 817-0387
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 01/14/2024
Date that the sample was received by the laboratory/organization performing the testing: 01/14/2024
The quantity of what the sample constitutes: 140 cu. yd. approx.
A brief description of the sample: ISR-RSC
From where was the sample collected: Job Site
Laboratory sample identification: 24-0138
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: SLC
The concrete mix design number: CTS-65-GBR
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 1
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: from volumetric concrete mixer truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2024-01-14-6-1
Test Method: CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete
Verified Date: 01/19/2024
Date Tested: 01/17/2024
Submitted By Organization: CT D07 - Materials Field Laboratory, Unit 1953
Organization Address: 1940 South Workman Mill Road,
Organization City: Whittier
Organization State: CA
Organization Zipcode: 90601
Organization Email: chad.chotibhongs@dot.ca.gov
Organization Phone: (213) 817-0387
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Number of specimens
|
3
|
Does the testing machine measure load or stress on the beam specimen?
|
Load
|
Fracture initiates in the tension surface
|
Within the Middle Third of the Span Length
|
Fracture occurred at a capped section
|
No
|
Is a beam dimensional correction factor used?
|
No
|
Age of specimen
|
3 days
|
Modulus of rupture
|
680 psi
|
Modulus of rupture 2
|
630 psi
|
Modulus of rupture average
|
660 psi
|
Modulus of rupture 3
|
670 psi
|